Healthcare Provider Details

I. General information

NPI: 1427328665
Provider Name (Legal Business Name): GIGI HSIAO O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2012
Last Update Date: 01/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10118 BANDLEY DR STE C
CUPERTINO CA
95014-2155
US

IV. Provider business mailing address

10118 BANDLEY DR STE C
CUPERTINO CA
95014-2155
US

V. Phone/Fax

Practice location:
  • Phone: 408-253-3235
  • Fax:
Mailing address:
  • Phone: 408-253-3235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number10081TPA
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: